Head Injuries in Rugby vs. Football 


By now, the National Football League is as well-known for its link to head trauma — and the devastating consequences that follow when the league does not take the issue seriously —  as it is for the elite athleticism and iconic American culture that it embodies.

But now, for better or worse, American football has company in the controversy over head trauma. The International Rugby Board, based in Ireland, is now host to a similar heated debate over regulations of the game, protections for players and protocols for when a player sustains a head injury.

As is the case in the NFL, the groundwork for the controversy was laid long ago.

Establishing Procedures

The spark that made the issue catch fire in the rugby world happened in July 2013. An Australian rugby player collided violently with another player and stumbled off the field, visibly groggy and disoriented. To everyone’s surprise, however, he returned to the game only a few minutes later.

Within those few minutes, the Australian player would have been administered an “off-field cognitive test” — essentially, an audit of his symptoms and a brief test of his balance, memory and other basic functions. The International Rugby Board’s Procedures and Definitions, drafted in 2011 in response to the growing number of brain injuries sustained by players, require this test to be administered to players who sustain severe injuries during a game.

However, the administration of these tests is truer to the letter of the law than to the spirit. Players are commonly sent back to the field or, at the very least, not advised to stay off, within a few minutes of the cognitive test being issued. This in spite of the 2011 rules, which note that concussion signs and symptoms evolve over time, and that there isn’t a definite time limit for determining the seriousness of a head injury.

Scottish rugby player Rory Lamont, who recently retired from the game directly because of this issue, has become the issue’s most outspoken critic. He recounted the Australian player incident this way:

“Everyone saw George wobbling his way off the field, clearly concussed, and then come back on. I know the protocols inside out and there is no way a player should be allowed to stay on the pitch after a head knock. It’s insanity. We are seeing reckless disregard for players’ welfare right now.”

The Grim Statistics

New Zealand journalist Ben Heather wrote a thorough exposé of the issue, speaking with current and retired rugby players about their experiences with injuries and treatment. He cited the following sobering statistics:

  • rugbyAbout 1,200 people suffer head injuries while playing rugby each year.
  • About two-thirds of these injuries are either concussion or brain injuries.
  • Rugby players are believed to play more aggressively when using scrum caps, which studies have shown make no difference for protecting against head injury.
  • The figures do not account for ongoing health problems which cannot be directly linked to rugby injuries.
  • In total, more than 50,000 people seek medical attention for rugby injuries each year, costing about $60 million.

In 2011, Heather wrote, the Auckland University of Technology compared the number of catastrophic incidents (i.e., resulting in paralysis or death) in rugby with other sports between 1975 and 2005. It found that with the exception of England, rugby incidents worldwide showed 4.6 catastrophic injuries for every 100,000 players annually.

Confronted with these statistics, the response of a rugby official was terse: “Rugby is not NFL football.”

How Does the NFL Compare?

Comparable statistics from the NFL look like this:

  • 228 diagnosed concussions were reported during preseason and regular-season practices and games in the 2013 season.
  • However, one-third of all NFL concussions are left off the injury report.
  • Half of the time, injured players go right back to playing after an injury without missing a game.
  • Since the NFL redrafted its injury-related rules in 2009, the league saw a drop in the number of players placed on the injury report because of a concussion.
  • Week 12 of the NFL season is notorious for showing a sudden increase in concussions — experts speculate it has to do with how small, consistent blows to the head lower the threshold for concussion occurrence.
  • The same Auckland University of Technology report showed American football resulting in 1.0 catastrophic incidents per every 100,000 players between 1975 and 2005. That’s more than 75% fewer incidents than the index tallied in rugby.
  • Unlike American football, rugby offers minimal protective gear and

While it can be argued that professional players of both football and rugby are ultimately responsible for the risks of their job, the precedent set by professional sports has a chilling trickle-down effect to amateur, college and children’s sports. Only last May, Canadian Rowan Stringer fell unconscious after a tackle in a high school rugby match…and never woke up.

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